Publications by authors named "Takaaki Osawa"

Article Synopsis
  • - The study examined the effectiveness of fundus-first laparoscopic cholecystectomy (FFLC) as a surgical option for severe cholecystitis by comparing outcomes from two groups of patients: one before and one after FFLC became common practice.
  • - Results showed that after FFLC was introduced, there was a significant increase in its usage, a decrease in laparoscopic subtotal cholecystectomy cases, fewer instances of bile duct complications, and a shorter average hospitalization time for patients.
  • - Overall, the findings suggest that FFLC leads to better surgical outcomes for patients with severe cholecystitis, demonstrating its value as an effective surgical technique.
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Polyglycolic acid (PGA) felt has been used to prevent clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD). However, there has been no related research on Blumgart anastomosis. Therefore, this study aimed to investigate the practical significance of Blumgart anastomosis with our new method involving PGA felt to prevent CR-POPF following PD.

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Background: The criteria for deciding upon non-operative management for nonocclusive mesenteric ischemia (NOMI) are poorly defined. The aim of this study is to determine the prognostic factors for survival in conservative treatment of NOMI.

Methods: Patients with bowel ischemia were identified by searching for "ICD-10 code K550" in the Diagnosis Procedure Combination database between June 2015 and May 2020.

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Introduction: Recent reports have shown laparoscopic gastric devascularization and splenectomy (Hassab's procedure) to be a safe and effective treatment for esophagogastric varices with portal hypertension. However, the long-term postoperative results remain unclear.

Methods: Between 2009 and 2015, 17 patients with portal hypertension and esophagogastric varices underwent laparoscopic Hassab's procedure at our institution.

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Article Synopsis
  • The da Vinci Surgical System (DVSS) is becoming more popular for general surgeries, including inguinal hernia repairs, particularly in the USA, with over 5500 systems installed globally.
  • While studies suggest robotic surgery is safe and feasible for hernia repair, there is no strong evidence proving it is superior to traditional open or laparoscopic methods in terms of long-term outcomes.
  • Robotic surgery may offer advantages like reduced complications, less postoperative pain, and a quicker learning curve for surgeons, but its implementation remains limited in many countries.
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A 55-year-old man underwent Hartmann's procedure for generalized peritonitis caused by perforation of sigmoid colon cancer, which was histologically diagnosed as tubular adenocarcinoma penetrating the muscularis propria (T3). The extent of lymph node dissection was insufficient for the advanced cancer, according to the concept of complete mesocolic excision. Two months after surgery, he underwent laparoscopic Hartmann's reversal, combined with interval lymphadenectomy.

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Aim: Drain fluid amylase concentration (DFAC) has been reported as a predictor of clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatectomy. However, the clinical significance of measuring the total drain fluid amylase amount (DFAA) considering the daily drainage volume of CR-POPF remains unclear.

Methods: Data from 216 consecutive patients who underwent pancreaticoduodenectomy (PD) (n = 126) or distal pancreatectomy (DP) (n = 90) between August 2014 and November 2020 were reviewed.

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Background: Advanced hepatocellular carcinoma (HCC) can often spread as intrahepatic metastases. Extrahepatic metastasis (e.g.

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Background: Symptomatic congenital biliary dilatation (CBD) during early infancy is always characterized by cystic dilation of the common bile duct with a narrow segment connecting the pancreatic duct.

Case Presentation: In two consecutive infants with a prenatal diagnosis of CBD, we found that biliary sludge had formed in the cyst upon the appearance of symptoms including acholic stool and hypertransaminasemia. Infrared absorption spectrometry revealed that the sludge consisted of calcium bilirubinate.

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Article Synopsis
  • A 35-year-old man with a history of left undescended testis experienced abdominal pain and was found to have a large pelvic mass, identified as a seminoma, after emergency surgery.
  • The case highlights the importance of monitoring for malignancy in individuals with an empty scrotum, as potential tumors can develop even years after surgery.
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Objective: There are no previous studies analyzing the prognostic predictive value of adding the tumor factor (i.e., Tumor Burden (TB) score) to the Controlling Nutritional Status (CONUT) score for patients with hepatocellular carcinoma (HCC).

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Background: A Killian-Jamieson diverticulum is a rare pharyngoesophageal diverticulum that is radically treated by diverticulectomy. However, there is no consensus on whether cricopharyngeal myotomy is necessary, and the optimal surgical methods that prevent postoperative complications such as leakage are undetermined.

Case Presentation: A 49-year-old man was referred to our hospital with oropharyngeal dysphagia while eating.

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Background: Recently, diagnostic criteria for malnutrition have been proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN). This study aimed to investigate the utility of the ESPEN malnutrition criteria as a predictor for major complications following hepatectomy and pancreatectomy.

Methods: Data were reviewed from 176 consecutive patients who underwent hepatectomy (n = 103) or pancreatectomy (n = 73) between November 2017 and December 2019.

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Aim: Robotic surgery using the da Vinci system has markedly increased worldwide. However, robotic inguinal hernia repair remains unpopular outside the United States. We introduced and evaluated a robotic transabdominal preperitoneal repair (R-TAPP) technique for inguinal hernia in our hospital.

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Background: Detection of common bile duct (CBD) stones is a major objective of intraoperative cholangiography (IOC) in laparoscopic cholecystectomy (LC). We evaluated the feasibility and safety of the routine use of transcystic choledochoscopy following IOC (dual common bile duct examination: DCBDE), which may improve the diagnostic accuracy of CBD stones and facilitate one-stage clearance, in LC for suspected choledocholithiasis.

Methods: Between May 2017 and November 2018, 38 patients with suspected choledocholithiasis were prospectively enrolled in this study, regardless of whether they underwent endoscopic sphincterotomy.

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Background: Based on the spatial relationship of an aberrant right hepatic duct (ARHD) with the cystic duct and gallbladder neck, we propose a practical classification to evaluate the specific form predisposing to injury in laparoscopic cholecystectomy (LC).

Methods: We retrospectively investigated the preoperative images (mostly magnetic resonance cholangiopancreatography) and clinical outcomes of 721 consecutive patients who underwent LC at our institute from 2015 to 2018. We defined the high-risk ARHD as follows: Type A: communicating with the cystic duct and Type B: running along the gallbladder neck or adjacent to the infundibulum (the minimal distance from the ARHD < 5 mm), regardless of the confluence pattern in the biliary tree.

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Purpose: Knowledge of mesenteric venous anatomy is important to safely perform laparoscopic complete mesocolic excision (CME) of the right colon. Despite their previously reported diversity, consistent features of the right colonic and pancreatic veins can be discerned. The objective of this study was to evaluate anatomical consistency of the right colic vein (RCV) and the pancreaticoduodenal vein associated with the colic vein (PDV-C).

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Introduction: Laparoscopic subtotal cholecystectomy (LSC) has been recognized as an alternative to conversion to laparotomy for severe cholecystitis. However, it may be associated with an increased risk of recurrent stones in the gallbladder remnant. The objective of this study was to evaluate the safety and feasibility of the complete removal of the gallbladder cavity in LSC for severe cholecystitis using the cystic duct orifice suturing (CDOS) technique.

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We examined the feasibility of umbilical diverting ileostomy for overweight and obese patients with rectal cancer undergoing laparoscopic surgery. Four patients who were overweight or obese (BMI > 27 kg/m ) were initially scheduled for the creation of a conventional loop ileostomy. Intraoperatively, however, this was considered too complicated because of thick subcutaneous fat, bulky mesentery, or both.

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A 73-year-old man underwent abdominoperineal resection for a rectal cancer. He developed a hip pain 3 years and 6 months after the surgery. A CT scan revealed a local recurrence in the perineum and multiple lung metastases in the bilateral lung.

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Although systemic multidrug chemotherapy is the first-line therapy for unresectable colorectal cancer, hepatic arterial infusion chemotherapy(HAI)may be a potential alternative treatment for patients with unresectable colorectal liver metastasis. A 65-year-old man underwent sigmoidectomy for sigmoid colon cancer with bilobar, multiple liver metastases. Postoperatively, an HAI regimen of 5-fluorouracil(5-FU, 1,000mg/m²/5 h/every week)was administered for 26 weeks; the total dose of 5-FU administered was 52 g.

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Article Synopsis
  • A rare case of an intra-abdominal sterile abscess due to remnant clips was reported in a 74-year-old woman following laparoscopic sigmoidectomy two years prior.
  • Imaging revealed a fluid accumulation with clips, prompting a fine-needle aspiration that showed no cancer cells.
  • Ultimately, abdominal surgery was performed to address the abscess, highlighting the need to minimize the use of clips during laparoscopic procedures.
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